At a time when health care spending is an enormous drain on most states' coffers, Delaware has doubled its funding for an ambitious cancer initiative that stands out as an example of novel health coverage on a tight budget.
At the behest of Gov. Ruth Ann Minner, who lost her second husband to lung cancer in 1991, the Delaware Legislature approved a budget in June that allocates $10 million to help residents stricken with cancer.
Some of the money will aid early detection through screening, but a significant chunk focuses on guaranteeing treatment for cancer patients without health insurance.
"It's going to improve the quality of life for many, many cancer patients who otherwise would not be able to receive adequate treatment," said Cathy Holloway, the American Cancer Society's government relations manager.
Delaware's cancer incidence and mortality rates are among the highest in the nation, although the state's rates peaked in the early 1990s. In Delaware, cancers of the lung, female breast, prostate, colon and rectum are among the most common. While campaigning in the late 1990s, Minner, a Democrat, heard more about cancer than any other issue.
"There is no one in Delaware who doesn't know or isn't related to someone who has been touched by cancer," Gregory Patterson, the governor's spokesman, said.
Minner vowed to make the struggle against cancer one of the centerpieces of her administration. After her election in 2000, she stayed true to her word.
Minner quickly created the Delaware Advisory Council on Cancer Incidence and Mortality, a group that studied the disease in the First State and provided recommendations to bring it under control.
Based on those suggestions, Minner asked the Legislature for, and received, $5 million in 2003 for the first phase of her initiative. Initially, the state budgeted the money exclusively for screening and early detection. Minner pushed for more.
In her 2004 State of the State address, Minner asked for $10 million to sustain the original program plus cover health care for cancer patients lacking insurance. She said that while cancer rates and mortality had been falling in Delaware over the past few years, there was still more to do.
"Cancer victims without health insurance receive less than 60 percent of the health care that cancer patients with health insurance get," Minner said in her address. "This means that health insurance for cancer victims can be the difference between life and death."
The Legislature approved the budget before adjourning June 30. The initiative went into effect the next day and will cover eligible patients, diagnosed after July 1, for up to one year after their initial treatment.
Holloway of the American Cancer Society described the coverage as an expansion of the state's current Medicaid system, with most of the money going to those with too much income to receive Medicaid but not enough to pay for insurance premiums out of their own pockets. She said the state pulled the money from its share of a $20 billion bailout package Congress provided for struggling state budgets last year, and the initiative faced no objections from the Legislature.
"I've heard lots of stories from people who fell through the cracks with mounting medical bills. I'm excited there's a program now where people can have insurance and get good-quality care for their cancer," Holloway said. "I think it will be a model for other states."
While Delaware is the only state guaranteeing health benefits for uninsured cancer patients, other states have programs aimed at donating medicine.